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1. Tendon Inflammation
The most important factor in carpal tunnel syndrome is inflammation of the flexor tendons. This is, by far, the most prevalent and also one of the more misunderstood underlying causes. The flexor tendons (on the palm side of the hand) can become inflamed by any one of a number of different factors. Most researchers believe, although not scientifically proven yet, that the most common reason is overuse or repetitive strain of the hand and wrist.
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People in an occupation where the hand is either constantly flexed or flexed and extended might be at higher risk for developing carpal tunnel syndrome. Over-worked tendons (by overstretching) can form micro-tears which produce local inflammation. The body reacts by trying to protect and repair the tendons with cushioning lubricant, produced by the sheath surrounding the tendons. Injury produces more lubricant that’s also more viscous. This causes more friction around the tendons as the wrist flexes and extends, which in turn produces even more inflammation and swelling. Finally, the swollen tendon exerts pressure on the adjacent median nerve causing symptoms of carpal tunnel syndrome.
2. Body Fluid Imbalance
Particular conditions like pregnancy, obesity, menopause, kidney failure, and thyroid disorder can cause alterations in levels of body fluids. For instance, hormonal changes during pregnancy often cause fluid retention. When the fluids are accumulate in the joints like the wrist, pressure increases inside the carpal tunnel. That exerts pressure on the median nerve. While carpal tunnel syndrome is common during pregnancy, it usually resolves soon after delivery. However, a significant percentage of women can still have symptoms of carpal tunnel syndrome up to three years after delivery.
3. Structural (Anatomical)
Changes in the arrangement of the carpal bones commonly occur with wrist fractures that have improperly aligned or healed. This can also occur from callous formations resulting from long term physical stress. Some pathologies like tumors can cause similar changes to a bone’s anatomy producing the same results. Misalignment of the carpal bones causes the transverse carpal ligamentto become taught, exerting pressure the carpal tunnel. That produces internal pressure directly on the median nerve. It also results in decreasing the volume of the carpal tunnel, causing the components inside the carpal tunnel (including the median nerve) to become squeezed. Also, when compressive forces are applied directly to the ulna and radius bones (as with weightliftingand benching exercises) tremendous inward forces inside the wrist joint are transmitted to the median nerve.
Pushing activities (by mail handlers and airline baggage personal) involving extension of the wrist and pushing with the palm can lead to this condition as well. Finally, there can be misalignment of carpal bones caused by myofascial syndrome (a dysfunction of the tissues around the muscles and fascia of the forearm and hand). These tissues become shorter and tighter, thereby pulling on their attachment points on the carpal bones and producing misalignment.
4. Nerve Damaging and Inflammatory Conditions
There are some chronic conditions like alcoholism and diabetes that are associated with increased risk of carpal tunnel syndrome. These illnesses directly damage the nervous system (including the median nerve) which is why patients with these conditions have a higher rate of carpal tunnel syndrome symptoms. Other conditions indirectly damage the median nerve by producing inflammation which is transmitted to the wrist joint. Examples are infection or rheumatoid arthritis which can disturb the normal functioning of wrist tendons, resulting in excessive pressure on the median nerve.
It’s not known why, but family history is strongly associated with having symptoms of carpal tunnel syndrome. A large proportion of people with a family history of carpal tunnel syndrome have physical characteristics known to be associated with its prevalence. In some individuals, there is a defect in collagen production, which forms the connective tissue between bones, ligaments, tendons, and muscles. The defective collagen is less supple, and this may lead to stresses in and around the tendon, producing inflammation and ultimately pressure on the median nerve.
6. Direct Compression, Vibration, and Temperature
Any occupation that involves direct compression upon the carpal tunnel can play a role is developing carpal tunnel syndrome. This is the problem with using the computer keyboard and mouse. One of the worst motions you can perform for your hands is to rest your wrist on a mouse while you reach for the click button. This puts direct pressure on the area of the carpal tunnel. Prolonging such posture will result in median nerve compression. This is identical to anyone who rests their wrists on a keyboard wrist pad or on a tabletop. Thus, proper posture at the keyboard is crucial. Another factor common to certain occupations is vibration. Workers who use vibrating tools such as chainsaws, jackhammers, grinders, air tools, and electric hand tools are at risk of developing carpal tunnel syndrome. Vibration inhibits blood flow to the nerves and other tissues of the hand and causes a type of repetitive strain injury sometimes called “vibration syndrome”.
Also, people who work outdoors or in cold environments tend to be more prone to getting carpal tunnel syndrome. The lower temperature causes a reduction in blood flow, and over long periods of time the cold inhibits the tissues in the wrist and forearm from recovering from micro-tears acquired with repetitive stress. This is why it’s unwise to use ice packs on the arms and hands while working at the computer or performing other repetitive tasks. Cold therapy should only be used when the wrist is at rest, and never during periods of activity.
7. Spinal Subluxations
Finally, spinal subluxations (misalignments of the spinal vertebrae), particularly of the lower cervical spine, produce swelling in the nerves leading to, and delivering sensations from the hand. Therefore, while the carpal tunnel itself may be perfectly normal, an irritated nerve near the spine can make it seem as though the pain is originating from the hand and wrist. Additionally, such irritation of the nerves leading to the hand can also produce inflammation on the muscles and tissues they supply throughout the length of the arm. This then may cause the muscles and tendons to become hypersensitive and, in turn, produce abnormal tensions in the forearm. The resulting abnormal mechanical forces are thus underlying cause of the carpal tunnel syndrome.
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Copyright 2014: The Carpal Rx is a product of Carpal Pain Solutions, Inc. All rights reserved. All information contained on this website is the property of Carpal Pain Solutions, Inc. and may not be reproduced without written permission. For more information, contact Carpal Pain Solutions, Inc. at info@CarpalRx.com
Information provided on this website and the content of articles & videos is not to be construed as medical advice. If you suspect that you have carpal tunnel syndrome, repetitive strain injury, wrist tendonitis or any other condition addressed within this publication you should consult with a qualified health care provider for a proper diagnosis of your symptoms.